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Biomedical subjects

H Manabe

Publications and source records attributed to H Manabe.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Present status and future view of cardiac surgery in Japan].

Analysis of present status: The institutes for cardiac surgery, amounting to 300 are spread throughout Japan. Consequently, the number of operation for the acquired heart disease, congenital heart disease and thoracic aortic aneurysm, has been counted 8088, 7837, and 839 respectively and in total, 16774 cases were operated in 1984. The increase in number of surgery for new born baby and infant recently proves the remarkable advance of cardiac surgery in Japan. The gradual increase in number of surgery for the aged reflects the Japanese social conditions today. The increase in number of aorto coronary bypass surgery should be paid attention, from the view of the disease structure in Japan. The problems, existing under today's condition are as follows; the establishment of the other department concerned with that of cardiac surgery, training condition to become specialists, practical use of medical resources and economical efficacy of medical care. Future view: It should be noted that the severe patients exist in Japan as well as in other countries and their lives cannot be saved without the heart or the heart-lung transplantation. We should immediately consider the organ transplantation as one of the medical treatments for the above-mentioned patients out of love for mankind. Heart transplantation is very much different from the general cardiac surgery in technical, ethical aspects and so on. Therefore, as the procedure for the success to establish heart transplantation as one of the medical treatments, careful consideration is indispensable in the nationwide.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Surgical Procedures↗
PubMed1985

Usefulness of left ventricular volume in assessing tetralogy of Fallot for total correction.

Ninety-one patients with tetralogy of Fallot underwent intracardiac repair between 1978 and 1981. One patient died from left-sided heart failure. Retrospective analyses of this death revealed a significant decrease of the left ventricular (LV) end-diastolic volume index (EDVI) of 21 ml/m2 (36% of normal). Results of early postoperative hemodynamic studies after total correction of this anomaly suggested that an EDVI of 30 ml/m2 is the minimal requirement for adequate cardiac output postoperatively. Based on these data, 3 patients with decreased LV volume with EDVI of around 30 ml/m2 were challenged with the primary repair with success, although they required atrial pacing and catecholamine support postoperatively to maintain adequate left atrial pressure and cardiac output. From these results, it is recommended that patients with tetralogy of Fallot and an EDVI of 30 ml/m2 or more can be considered as candidates for the primary repair, but that patients with an EDVI of less than 30 ml/m2 should be palliated once by systemic-to-pulmonary arterial shunt procedures. Subsequent total correction should be performed after sufficient LV growth for those patients.

Adolescent↗
PubMed1985

Rastelli operation as one stage anatomical correction for infants with complete transposition of the great arteries and ventricular septal defect.

We recently adopted the Rastelli operation as a one stage anatomical correction for three infants with transposition of the great arteries and associated with ventricular septal defect (TGA + VSD). In all, ventricular septal defect was enlarged by excision of the conus septum to avoid obstruction of intraventricular tunnel and Hancock valved conduits of 18 mm in diameter were used for reconstruction of pulmonary trunk. The postoperative function of the left ventricule proved to be better than that of the right ventricle, as the systemic ventricle, after the Mustard procedure for TGA + VSD. Our results show that the Rastelli operation is effective as a one stage anatomical correction in infants with TGA + VSD.

Female↗
PubMed1984

Isolation of tumor disturbing factor on the proliferation of tumor cells in human serum.

The classified sediment with ethanol from sera of nude mice and humans showed a disturbing effect on L1210 cells in vitro and a lifesaving effect on L1210 cell-bearing mice in vivo. This factor was purified more than 2300-fold to a specific activity of approximately 1 X 10(5) U/mg by ethanol classified precipitation, Sephadex G-200 gel filtration, DEAE cellulose ion exchange chromatography with Nacl and pH gradient aqueous solution, and preparative polyacrylamide gel electrophoresis.

Animals↗
PubMed1984

In-vitro and clinical evaluation of cardiac valve substitutes.

One of the major causes of postoperative morbidity and mortality after valve replacement surgery is the prosthetic valve substitute itself. In this discussion, therefore, we make a fundamental evaluation of hydrodynamic valve function and present our clinical results following valve replacement with the Björk-Shiley valve prosthesis, the Hancock porcine xenograft and the Ionescu-Shiley bovine pericardial xenograft. In an experimental study using a mechanical simulator system, the pericardial xenograft displayed superior hydrodynamic characteristics compared to other two valve substitutes. Postoperative hemodynamic evaluation further indicated that the pericardial xenograft performed significantly better than the porcine xenograft regarding transvalvular pressure gradient, effective valve area and cusp opening. In addition, data from 387 patients with aortic, mitral or both types of valve replacement who had received one of the three kinds of valve substitute were analyzed. Systemic thromboembolic complications occurred in one patient with an aortic Björk-Shiley valve (0.6% per patient-year), six with mitral Hancock xenografts (2.8% per patient-year) and one with an aortic and mitral Hancock xenograft (2.2% per patient-year). The incidence of prosthetic valve endocarditis was 0.84% per patient-year for the Hancock xenograft and 1.84% per patient-year for the Ionescu-Shiley xenograft. It was concluded that the hemodynamic and antithrombogenic advantages of the pericardial xenograft proven by our mid-term follow-up study make it the valve substitute of choice. However, careful attention is required regarding prosthetic valve endocarditis tissue heart valves, which are more susceptible to infection than mechanical ones, and the long-term durability of the pericardial xenograft remains to be confirmed.

Aortic Valve↗
PubMed1984

Clinical features of rheumatic heart disease in Bangladesh.

The clinical features of 205 cases of rheumatic heart disease in Bangladesh, including unique two-dimensional echocardiographic findings, were reported, and these were compared with those of 387 Japanese cases. The percentage of mitral stenosis (MS), aortic valvular diseases including both aortic stenosis and aortic regurgitation (A), mitral stenosis with aortic valvular diseases (MS + A) were almost the same between the two countries, but that of mitral regurgitation (MR) was higher, mitral stenosis and regurgitation (MSR) was lower in Bangladesh. The mean age of the patients with mitral valvular diseases was very young and the incidence of atrial fibrillation was very low in Bangladesh. Males predominated over females in MS (male/female = 1.2/1) and the incidence of pulmonary hypertension in MS was higher in Bangladesh. A two-dimensional echocardiographic examination showed that the rough zone was heavily involved in the rheumatic process with having a narrow mitral valve orifice while the clear zone was relatively spared and pliable in many patients with MS in Bangladesh. In MR, posterior mitral leaflets were shortened and made immobile by its submitral complex which were also thickened, fused and shortened, and these resulted in a gap or non-coaptation of the two leaflets in many patients.

Adolescent↗
PubMed1984

Circulation control of experimental and clinical profound left ventricular failures by automatic left ventricular assist system.

It is desirable that circulation control of the patient using a left ventricular assist device (LVAD) should be achieved appropriately and safely. We have developed an automatic LVAD system, which can maintain the normal circulation irrespective of the severity of heart failure and can restore the failing heart by decreasing the bypass flow (BF) through the LVAD as the heart recovers. The main part of the control-drive unit is an automatic level control (ALC) system for left atrial pressure (LAP) and total flow (TF). Profound left ventricular failure (LVF) was made by complete interception of blood supply to the extent of 50% (5 goats) and 70% (5 goats) of the LV free wall. The air-driven diaphragm-type LVAD was implanted between LA and aorta. At the beginning of LVAD pumping, BF tended to be very high to keep LAP at the preset level (0-5 mmHg) and to maintain TF at somewhat higher level (120-140 ml/kg/min). The recovering heart was able to decrease LAP gradually. Since the LAP was set at a certain level, the ALC of LAP decreased BF to maintain LAP at the preset level. During the recovering stage from LVF, preset level of LAP was gradually raised while checking the pulmonary function. When natural heart output exceeded 100 ml/kg/min, LVAD was removed. The 50% LVF group recovered between 17 hours and 3 days, and 70% LVF group between 6th and 16th postoperative day. This LVAD system was then applied to the postoperative profound LVF in a MVR patient whose entire circulation was maintained normal during 14 day pumping. The failed heart gradually recovered and the pump was successfully removed. We consider that the decompression of LV will prevent overextension of impaired myocardium and simultaneously accelerate the solid scar formation. And gradual increase of LV work will promote the compensation ability of the residual myocardium. Continuous LVAD assistance can therefore earn time for the impaired myocardium to recover while maintaining normal circulation.

Adult↗
PubMed1984

[Left ventricular thrombus formation and cuspal fusion of the prosthetic valve during left heart bypass: their pathophysiological significance and echocardiographic observations].

The echocardiographic findings during left ventricular assist of a heart of a 36-year-old woman who underwent mitral valve replacement were described. Blood was bypassed from the left atrium to the aorta. Echocardiography demonstrated that the pulmonary and tricuspid valves functioned with each heart beat, but that the aortic and prosthetic mitral valves did not open, and the left ventricular wall did not contract. In the left ventricular cavity, there was a mobile and amorphous thrombus which correlated with dynamic intracavitary micro-echoes ("moya moya" echoes). With higher left atrial pressure, the left ventricular motion increased slightly, and the left ventricular dimension gradually decreased. These findings were interpreted as follows: (1) desired results were attained from the previous powerful assist, or (2) the most optimum pressure of the left atrium in relation to the left ventricle was relatively high. It has not yet been determined which is actually the case. The "moya moya" and thrombus echoes were decreased. The general condition of the heart appeared to be improved, but the prosthetic valve motion was not observed. Contrast study via an echocardiographically-guided catheter inserted retrogradely into the left ventricular cavity revealed prosthetic valve stenosis. Fusion of its cusps by fibrin was confirmed on repeat surgery. Although the patient's condition allowed removal of the left ventricular assist device after surgery, the patient died of progressive infection. Optimum powerful assist should be performed while the formation of thrombi and cuspal adhesions is being prevented by other methods, or a more mild assist may be desirable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗